1. Applying a Problem Solving Technique, DECIDE Activity Ethics of Interpreting B. Aron 2010

2. A Situation: You are interpreting for a patient in a doctors office. You are interpreting for a patient in a doctors office. The doctor said, Because you are taking this new medication RX-2, dont take this medication-RX-1 for three days or it will kill you. The doctor said, Because you are taking this new medication RX-2, dont take this medication-RX-1 for three days or it will kill you. Then you accompany the patient to different doctor for another problem the same patient has. Then you accompany the patient to different doctor for another problem the same patient has. The second doctor said, You need to continue to take medication RX-1 to help you resolve your problem. The second doctor said, You need to continue to take medication RX-1 to help you resolve your problem. The patient did not argue but took the prescription nodding her head as if she understood and is in agreement. The patient did not argue but took the prescription nodding her head as if she understood and is in agreement. What do you do as an interpreter? What do you do as an interpreter?

3. The DECIDE concept Now lets apply the DECIDE concept: Now lets apply the DECIDE concept: Dilemma: What is the dilemma? Dilemma: What is the dilemma? Ethic: Which tenet(s) does this situation Ethic: Which tenet(s) does this situation apply? apply? Choices: list all the choices possible Choices: list all the choices possible Impact: Who will it affect and how? Impact: Who will it affect and how? Decision: Make a decision based on the least impact Decision: Make a decision based on the least impact Effects: How will it effect everyone involved? Effects: How will it effect everyone involved?

4. Dilemma The patient will die if she does not disclose that she is taking RX-2 to the second doctor who recommended she continue taking RX-1 The patient will die if she does not disclose that she is taking RX-2 to the second doctor who recommended she continue taking RX-1 You will feel responsible if something happened to the patient You will feel responsible if something happened to the patient The doctors (both of them) may be liable The doctors (both of them) may be liable

5. Ethic Which of the RID Code of Professional Conduct does this situation impact? Which of the RID Code of Professional Conduct does this situation impact? Tenet 1: confidentiality, you are sworn to confidentiality, the patient is an adult and you should respect this. Tenet 1: confidentiality, you are sworn to confidentiality, the patient is an adult and you should respect this. Tenet 3 respect for consumers, respect for the right of the consumer to make choices Tenet 3 respect for consumers, respect for the right of the consumer to make choices

6. Choices 1. Remind the patient about the other medication she is taking which may conflict with the new RX. 2. Remind the doctor to check patients chart for an update 3. Rephrase/repeat what the first doctor said to the patient and hope she will remember to inform the 2 nd doctor on her own 4. Repeat/rephrase what the first doctor said in sign language and voice so that the 2 nd doctor will know what was being said 5. Say nothing and hope for the best.

7. Impact 1 st choice: Remind the patient about the other medication she is taking which may conflict with the new RX. Impact: Patient may not appreciate your stepping out of your interpreter role and being condescending Impact: Patient may not appreciate your stepping out of your interpreter role and being condescending 2 nd Choice: Remind the doctor to check patients chart for an update Impact: Doctor and patient may not appreciate your stepping out of line either. Impact: Doctor and patient may not appreciate your stepping out of line either.

8. Impact (contd) 3rd Choice: rephrase/repeat what the first doctor said to the patient and then add the second doctors directions to help remind the patient to inform the 2 nd doctor on her own Impact: Patient may not really understand the first set of instructions so repeating/rephrasing may clarify the first set of instructions with the second set of instructions. Impact: Patient may not really understand the first set of instructions so repeating/rephrasing may clarify the first set of instructions with the second set of instructions. 4 th Choice: Repeat/rephrase what the first doctor said in sign language and then voice so that the 2 nd doctor will know what was being said. Impact: You may be stepping out of line because that conversation occurred earlier and not in the second doctors room yet, you may just say you are reviewing what was said earlier and leave it at that. Impact: You may be stepping out of line because that conversation occurred earlier and not in the second doctors room yet, you may just say you are reviewing what was said earlier and leave it at that. 5 th Choice: Say nothing and hope for the best. That may be the worst impact as the burden will be on you and the doctors if something bad happened to the patient. Can you live with the consequences?

9. Decision I would choose Choice # 3: I would choose Choice # 3: I will just repeat/rephrase the first doctors instructions then add the second doctors instructions in case the patient did not really understand or forgot the first doctors instructions. This will put the responsibility to the patient to inform the second doctor of the conflict in the prescriptions. I will just repeat/rephrase the first doctors instructions then add the second doctors instructions in case the patient did not really understand or forgot the first doctors instructions. This will put the responsibility to the patient to inform the second doctor of the conflict in the prescriptions.

10. Effects 1. The patient is ultimately responsible for disclosure therefore confidentiality and respect for the consumer is maintained. 1. The patient is ultimately responsible for disclosure therefore confidentiality and respect for the consumer is maintained. 2. The doctor will hear directly from the patient so interpreter maintains her role as an interpreter in this interaction. 2. The doctor will hear directly from the patient so interpreter maintains her role as an interpreter in this interaction. 3. A potentially dangerous situation is thereby averted. 3. A potentially dangerous situation is thereby averted.

11. Ethics and Decision Making Circles A moderator will be chosen by peers in your circle. A moderator will be chosen by peers in your circle. Using the situation you chose for your journal, each person share the situation with your circle. Using the situation you chose for your journal, each person share the situation with your circle. Discuss how you apply the DECIDE concept to that situation Discuss how you apply the DECIDE concept to that situation Have others provide feedback/ask for clarification, add other options Have others provide feedback/ask for clarification, add other options Each person take turns sharing their situation and how they apply the DECIDE concept. Each person take turns sharing their situation and how they apply the DECIDE concept.